Role of Iron Isomaltoside 1000 in Treatment of Iron Deficiency Anemia in Obstetrics and Gynecological Patients

Abstract

Background: Pregnant women are particularly susceptible to iron deficiency anemia (IDA), a global health problem. Having an IDA is associated with poor outcomes for both the mother and the child. Due to the variety of laboratory tests available, the most commonly used are hemoglobin (Hb) and serum ferritin (SF). The standard treatment for IDA is intravenous (IV) iron. Aim and objective: Iron isomaltoside (IIM) 1000 (Rapifer IV) treatment in pregnant and gynecological patients was evaluated in this study. Materials and methods: Fifty pregnant women who were followed from the start of the second trimester until a few days before delivery were studied for IDA. For a minimum of 15 minutes, all women received the same dose of IIM 1000 mg (Rapifer IV). To determine the efficacy of the treatment plan, several tests were conducted, including estimations of Hb, red blood cell (RBC) count, white blood cell (WBC) count, platelet count, polymorphs, lymphocytes, eosinophils, monocytes, packed-cell volume (PCV), and mean corpuscular volume (MCV). When the ferritin level is 30 gm/L, severe iron deficiency (ID) is defined, while a mild-moderate ID is determined when the ferritin level is between 100 and 30 gm/L. Results: Mean age of women with IDA was 35.14 ± 7.183 which ranged from 22 to 53 years. Significant improvement in mean Hb (8.64 ± 0.85 vs 12.86 ± 0.97, p <0.001), platelet count (115.11 ± 161.22 vs 3.13 ± 0.68, p < 0.001), polymorphs (70.9 ± 34.36 vs 50.62 ± 6.39, p = 0.0001), lymphocytes (32.24 ± 9.70 vs 39.68 ± 7.64, p = 0.0001), PCV (31.40 ± 4.46 vs 39.72 ± 2.56, p = 0.023), MCV (74.51 ± 8.23 vs 87.14 ± 3.05, p = 0.021), mean corpuscular hemoglobin (MCH) (23.71 ± 3.77 vs 31.62 ± 2.10, p = 0.012), mean corpuscular hemoglobin concentration (MCHC) (27.56 ± 2.81 vs 34.90 ± 2.30, p = 0.001), red cell distribution width (RDW) (18.48 ± 3.02 vs 13.94 ± 1.62, p = 0.004), total iron binding capacity (TIBS) (397.1 ± 74.53 vs 273.86 ± 31.55, p = 0.024), SF (32.19 ± 78.18 vs 85.96 ± 21.74, p <0.001), serum iron (46.40 ± 14.89 vs 108.32 ± 21.38, p <0.001), and reticulocytes (1.84 ± 0.79 vs 1.07 ± 0.29, p <0.001) after 27th day treatment with IIM 1000 compared to baseline. A significant improvement in Hb was observed in obstetrics and gynecological (12.68 from 8.24; p <0.001) and postoperative women (13.22 from 8.62; p <0.001). IIM 1000 was also able to improve severe ferritin level to mild-moderate ferritin level in a span of 27 days. Conclusion: IIM 1000 (Rapifer IV) is efficacious in obstetrics and gynecological and postoperative women. A significant improvement was observed on the classical parameters of IDA.